Homebirth-Friendly OB Needs Your Help

An OB of a very rare breed, a homebirth, VBAC and vaginal breech supporter, Dr. Stuart Fischbein, who actively collaborates with midwives, needs your help.

He is currently being threatened with disciplinary action by his hospital for, in essence, doing his job to the very best of his ability: supporting informed consent and evidence-based medicine. His practice maintained a primary c-section rate of just 5% (as opposed to the hospital rate of 20%) and a total rate of 12% (compared to 29% for the hospital rate). Over the past few months, he has attended 3 vaginal breech birth and 3 VBACs which all ended positively. The hospital has already suspended the privileges of the two CNMs he works with, and he's next on their list.


To find out more about Dr. Fischbein's case and how you can support his cause, please visit his blog.


Here's more on how you can help:

1. Contribute to Dr. Fischbein's Legal Aid Fund. Make Paypal Payment to angelfischs@yahoo.com or mail a check payable to Alan J. Sedley, Attorney at Law to: 1234C Westlake Blvd., Westlake Village, CA 91361

2. Write a Letter to: Mr. Michael T. Murray, President, St. John's Regional Medical Center, 1600 Rose Avenue, Oxnard, CA, 93030 and copy to: angelfischs at yahoo.com.

3. File a complaint with the Joint Commission.

4. Network. Share his story with forums, blogs, newsletters, or start a letter-writing campaign. This issue is larger than him - it impacts birthing women everywhere.

5. Enroll in our Online Childbirth Classes. 10% of all tuition payments received in September will be donated to his Legal Aid Fund.


His hospital currently supports aggressive, non evidence-based policies which compromise patient rights, autonomy, bodily integrity and overall well-being in the interest of limiting professional liability.

For example, they ban VBAC patients, not from VBAC, but from receiving epidurals, which should always be a choice, whether or not a woman chooses to elect it.

They also have strict policies on homebirth transfers, limiting women in their choice of hospital, which could even be a violation of EMTALA, which states that no woman in active labor can be turned away from a hospital without treatment.

I strongly urge you to support Dr. Fischbein in any way you can - whether monetarily or otherwise. By supporting him, you are advocating for women's rights to quality, evidence-based care for themselves and their children. The consequences of inaction could be far reaching.

ACOG Steps Up the Anti-Homebirth Game

If ACOG were a dog breed, it would be a pit bull - tenacious and aggressive when threatened.


Their latest tactics include soliciting failed homebirth stories, with or without negative outcomes, via their website. It speaks volumes about their commitment to impartial, evidence-based policies backed in rigorous research evidence, doesn't it, that they aren't also asking for statistics on successful homebirths. It's a one-sided petition that suits their politics perfectly.


From the ACOG site:

Reporting of Unsuccessful Attempts at Home Delivery with or without Adverse Consequences

In 2006 there were 24,970 home deliveries reported in the United States[1]. Obstetrician-gynecologists and other members of the medical community may be faced with the presentation of an obstetrical patient who has attempted home delivery unsuccessfully. The need exists to quantitate the frequency and information of these events. The goal of this registry is to attempt to quantitate when home delivery is unsuccessful and what the outcomes are. To be HIPPA-compliant, no identifying information will be requested. Data points include the state of occurrence, as well as the month and year of delivery, maternal and gestation age, gravidity and parity and obstetric or neonatal complications. An attempt to identify the home attendant type if known will also be useful data.

ACOG appreciates your recognition of this issue and your utilization of this registry to assist us in data collection.

In a backlash they never saw coming, ACOG got data - just not the data they expected.


Their collection form was instead flooded with the positive homebirth stories of mothers nationwide who've had enough of their unfounded attacks on homebirth, midwifery and women's rights in general, and decided to fight back.


After this outpouring of positive homebirth support, ACOG put their submission form on a members-only, login page: http://www.acog.org/survey/hdComplications.cfm


Maybe they'll take the hint and put their self-interested policies locked far, far away from women, right where they belong.


If they do make the form public again, rest assured that the positive flood of homebirth stories will resume - they'll get the message one way or another, eventually.

Abby & Ricki Overdeliver Again: Webisode Series at MyBestBirth.com

Abby Epstein & Ricki Lake, who produced the ground-breaking documentary, The Business of Being Born, are again giving back to the birth world through their new site, MyBestBirth.com.

They're currently launching a series of celebrity webisodes covering the homebirths of different celebrities who've had homebirths. The full press release & details is posted below. Be sure to check it out!

RICKI LAKE LAUNCHES EXCLUSIVE CELEBRITY WEBISODE SERIES ON MYBESTBIRTH.COM
Cindy Crawford, Christy Turlington, Laila Ali, Melissa Joan Hart, Alyson Hannigan are among featured celebrities sharing personal birth stories as part of the series

Los Angeles, June 25, 2009--Ricki Lake and Abby Epstein, the documentarians behind the critically-acclaimed film The Business of Being Born and authors of Your Best Birth, will exclusively preview clips of their new film on MyBestBirth.com as a webisode series. This includes, never-before-seen interviews from celebrities Cindy Crawford, Christy Turlington, Melissa Joan Hart, Alyson Hannigan, Laila Ali, Kellie Martin, Sarah Wayne Callies, Kimberly Williams-Paisley, Joely Fisher and others, discussing their personal birth experiences.

Cindy Crawford’s birth story began the series on July 8th and it will culminate with an online chat with Crawford herself answering people’s questions from July 27 to 31 on MyBestBirth.com. The other celebrity stories will immediately follow.

Cindy Crawford’s birth story websiodes can be viewed at:
http://www.mybestbirth.com/page/cindy-crawford-part-1

The trailer for the webisode series can be viewed at MyBestBirth.com or http://www.youtube.com/mybestbirth.

For more information, please visit MyBestBirth.com or contact Amy Slotnick at Amy@mybestbirth.com

# # #

About Ricki Lake:
Actress, producer, filmmaker and author Ricki Lake has reinvented herself at every stage of her 20 year career. Lake has gone from starring in the 80s classic Hairspray to hosting the long-running Ricki Lake talk show for 11 years—while continuing to star in feature films and appear in television projects. Lake has again evolved her career—this time to include birth advocate, documentarian and author with the recent releases of the critically-acclaimed film The Business of Being Born and pregnancy guide, Your Best Birth. Proving that her entertainment influence will always be multi-hyphenated, she presently hosts and executive produces the Vh1 hit series, Charm School with Ricki Lake.

About Abby Epstein:
Director and Producer Abby Epstein helmed the acclaimed documentary The Business of Being Born, executive produced by Ricki Lake. The success of the film inspired Abby and Ricki’s recent book, Your Best Birth. Abby made her film directing debut at the 2004 Sundance Film Festival with the documentary feature, Until the Violence Stops. On Broadway, Abby spent four years as the resident director of the musical RENT, overseeing the London premiere and two National Tours. She directed RENT in Mexico City, Barcelona and Madrid. Off Broadway, Abby directed over 100 celebrity actresses in The Vagina Monologues along with the National tour and premieres in Toronto and Mexico City.

Expanded Midwifery Care in Ireland

Here's a positive article on the expanded use of midwives in Ireland.


It's a good read that highlights many of the benefits of midwifery care. Enjoy!

Campaign to Change Hospital Policy Against Midwifery Care

I received this email from an expectant father seeking help in changing a local hospital's policy on midwives attending births. If you live in the area (and even if you don't), please consider making a phone call or sending a letter/email to the hospital administrator to heighten awareness of the issue and hopefully change hospital policy for the benefit of mothers and babies:

My wife and I are expecting our first in September. We are eager and excited to work with a specific midwife/nurse practitioner who works in a woman's health office near our home. This office is connected with Holy Cross Hospital in Silver Spring, Maryland. For this reason, we can not work with our midwife during birth because Holy Cross does not allow midwives to help women deliver in their hospital. They are the only hospital in our region that does this horrible practice. I was hoping you could help get the word out and help me to begin a campaign with the hospital leadership.


The president of the hospital is:

CEO and President: Kevin Sexton

Holy Cross Hospital

1500 Forest Glen Rd.

Silver Spring, MD 20910

301-754-7010
E-mail Address: sextok [at] holycrosshealth.org

~~~~~~~~~~~~~~~

If you've never phoned, written or emailed such a letter, here are some sample scripts with talking points to include:

"My name is ____________________. I live in _______ near ________ hospital. I wanted to share with you how the lack of access to midwifery care at ________ hospital has affected me and other women and families in the vicinity. (List 1 or 2 examples from the list below or add your own).

• I chose to travel ____ miles rather than give birth in this hospital due to the lack of midwifery care providers


• I had to choose a provider I'm not comfortable with because of the lack of midwifery care at this hospital


• Parents have the right to choose how, where, and with whom their children will be born.


• Women deserve to have access to all the nationally certified maternity care providers that women in other states, like Wisconsin and Minnesota, can choose from -- including CPMs


• Midwives are known to do an excellent job working with under-served populations, including undocumented worker populations, who are more accustomed to midwifery care in their home countries


• With obstetricians leaving that profession, midwives can help fill the gap for normal births in a cost effective fashion


• With their unique out-of-hospital training, Certified Professional Midwives can be a vital part of emergency services in times of epidemics, natural disasters or terrorist attacks (when hospitals might be overwhelmed with actual medical emergencies), allowing obstetricians to oversee the cases that required their surgical expertise


• I want the option of midwifery care available for my children,
  when they start to have children of their own

(You should pick the talking points that make the most sense in your situation and/or best represent your point of view or comfort level.)

"I hope that in light of these factors, you will reconsider your policy and allow midwives to have privileges within this hospital to attend to birthing women and their families. Thank you for your consideration in this matter."


Please spread the word to help this and other families in the area gain full access to the care providers of their choice.

How Different They Are...

Yesterday, I ran across this article, which details the story of a UK mother with a history of precipitous labor (labor lasting less than 3 hours), who chose a homebirth (which nearly became an unassisted birth) with her last child to avoid giving birth en route to the hospital.


She and I share commonality in that both my labors were also precipitous. My first was born in 3 hours and my second in a mere 45 minutes.


As I read further, I was struck by a seemingly small detail, but one that truly crystallizes the differences between the US and UK maternity systems:

"After Charlotte was born doctors had recommended that Hazel have a home birth if she ever fell pregnant again..."

Ummm, did I read that correctly?


In the US, homebirth would never be suggested as the solution to precipitous labor. I can personally attest to the one-and-only US answer: "medically necessary" induction.


In my case, this would mean inducing between 36-37 weeks, as both my children were also born before 38 weeks.


So, despite the fact that precipitous labor at term is typically moving so quickly because it is completely uncomplicated, because everything is going right, I would be forced, not only to undergo a decidedly unnecessary induction with all the added risks it entails, but also at the additional risk of delivering a pre-term infant, and all in the name of "preventing complications".


This is a perfect example of how overmedicalized the US system is: instead of letting labor progress normally on its own, the desire for a false sense of control makes modern obstetricians believe they must save me from myself, that only by their aggressive intervention could I be saved from the risk of birthing in my own time, in my own home.


In all probability, my next birth will be unassisted, not as an active choice, but due to the lack of one.



My choices are:


1. Plan a hospital birth

This means accepting an induction and all its ancillary interventions between 36-37 weeks. There are no birth centers in my state, so that is not an option, although even in a birth center, induction would be my only option. I have interviewed all the insurance-covered OBs in my area and this is the consensus, take it or leave it.

2. Plan a midwife-assisted homebirth

Due to the lack of support for midwifery care from the medical maternity model, the nearest midwife to my home is still over an hour away. Were my next birth to go as quickly as my second, it's highly unlikely she would arrive before the baby did. Even if we called from the very first contraction, I doubt there would be enough time for her to get to our house.

So, what to do? Most likely, I will choose a midwife, paying four times as much for her care (since my insurance won't cover midwifery care), all the while knowing she probably won't be present for the birth.



While many would baulk at the thought of an unassisted birth, I accept that, whether I want it or not, this may well be the reality of birthing again. As such, I don't spend time worrying about this fact; rather, I can focus on preparing everything needed to birth as safely as possible at home.


If modern obstetrics truly cared about making birth as safe as possible, then their focus would be on practicing evidence-based medicine and recognizing when intervention was truly necessary. Thus, the midwifery model of care would be the standard, so that women such as I could birth safely with a skilled attendant present no matter what place of birth was chosen.

The MEAC Needs Your Help

Feel free to pass this along and support midwifery across the US. Donations are also tax-deductible.


October 2008

Dear Friend of the Allied Midwifery Organizations,

MEAC needs our help!

MEAC is the Midwifery Education Accreditation Council. MEAC promotes excellence in midwifery education by supporting and accrediting midwifery schools around the country that prepare midwives for national certification as CPMs. MEAC is doing exciting, groundbreaking, and vital work for our midwifery movement. Just this month, the Milbank Memorial Fund, a non-partisan institute devoted to health policy analysis, issued a new report titled, “Evidence-Based Maternity Care: What It Is and What It Can Achieve”. The report cites data from the landmark study of CPMs published in 2005 and concludes:


The low CPM rates of intervention are benchmarks for what the majority of childbearing women and babies who are in good health might achieve.


MEAC currently accredits eight free-standing institutions and two programs that reside within universities, providing excellent midwifery education for more than 500 matriculating students.


Why does MEAC need our help now?


This year, the U. S. Secretary of Education deferred a decision to extend recognition of MEAC, requesting that MEAC provide evidence of a stronger financial and volunteer base. It is ESSENTIAL that MEAC satisfies the requirements to continue its recognition by the USED. This appeal to you hopes to accomplish two things:


1. Increase the capacity of MEAC’s Reserve Fund to cover one year’s operating budget ($120,000).

2. Demonstrate to the USED that MEAC has a strong base of support that can be called upon to respond swiftly and effectively in a time of need.


Please help us in this one-time capital campaign. We have come so far in the last decade. We can’t let it slip away. Your support is crucial and so much appreciated at this time! Please give generously. Large donations of $500-$1,000 will provide significant support. Smaller donations will help, step-by-step, to achieve this goal. We can do this together- it is an investment in our future!


Sincerely Yours,

The Leadership of the Allied Midwifery Organizations


*Donations to MEAC are tax deductible!
Make checks payable to MEAC, POB 984, LaConner, WA 98257,
http://www.meacschools.org